Eating disorders in pregnancy

Here we discuss eating disorders in pregnancy, with information on how to recognise the signs and how to get the support you need.

It’s natural to put on weight during pregnancy, but it can bring up difficult feelings for some women. Eating disorders might return or develop during pregnancy (Ward, 2008). Eating disorders can sometimes also improve during pregnancy with a new focus on the health of the unborn baby (Rocco et al, 2005).

Here we answer the questions you might have about eating disorders in pregnancy.

What are eating disorders?

Eating disorders are complex mental illnesses, characterised by developing unhealthy eating habits. These habits might lead to obsessing over food or body weight, which can reduce nutritional intake and make people very ill (NICE 2017; NHS, 2018a).

The most common types of eating disorders are:

  • Anorexia – eating too little and/or exercising too much.
  • Bulimia – eating a lot of food and then deliberately being sick or taking laxatives. The person might also restrict what they eat and/or exercise too much.
  • Binge eating – when someone regularly loses control of their eating and eats so much they feel too full, upset and/or guilty.
  • Other specified feeding or eating disorders (OSFED) that don’t fit into the above categories but are still serious.

(NICE 2017; NHS, 2018a)

What are the signs of an eating disorder in pregnancy?

If you or someone else is worried about your eating habits, you might have an eating disorder.

"Eating disorders can surface when people feel sad, angry, distressed, down or anxious as a way to cope with how they’re feeling. Often, people with eating disorders keep them secret for a long time. Eating disorders like anorexia are serious but treatable illnesses, so it’s important to get help (Beat, 2017)."

Some women find their eating disorder resolves itself during pregnancy but returns after they’ve had their baby (usually after six months). Others develop an eating disorder for the first time when they’re pregnant or after their baby is born (Ward, 2008).

Signs of an eating disorder might include:

  • Eating very little food, deliberately making yourself sick, or taking laxatives after food.
  • Having very strict rules or habits about food.
  • Exercising too much.
  • Avoiding eating with others, being secretive about food and/or binging on food excessively.
  • Underweight or unusually low body mass index compared with your healthy counterparts of the same age.
  • Missing meals or avoiding food that you see as fattening.
  • Taking medication to reduce hunger.
  • Periods stopping in women or not starting in younger girls.
  • Physical problems such as dizziness, hair loss or dry skin.

(NHS, 2018b)

Some other pregnancy-related conditions might share some but not all of the symptoms of an eating disorder. These include:

  • Suffering from morning sickness (nausea and being sick during pregnancy), food cravings or food aversions during pregnancy
  • Hyperemesis gravidarum (excessive nausea and vomiting during pregnancy).

(NICE, 2017)

Eating and pregnancy conditions like the above can improve with treatment. If you or someone you know might have an eating disorder during pregnancy, make sure you seek help to ensure an accurate diagnosis and treatment plan. The sooner you seek support, the better (NICE, 2017).

How will an eating disorder affect me during pregnancy?

It’s important to eat a healthy diet during pregnancy to help your body cope with the physical demands of pregnancy and to meet the nutritional needs of your growing baby (NICE, 2014).

Eating disorders can affect you emotionally as well as physically.

  • Pregnancy can be a stressful and anxious time for women, especially for those with an eating disorder. Getting support from your partner and a health professional will help (NICE, 2017).
  • Accompanying weight gain and changes to your body shape during pregnancy can lead to recurrence or worsening of an eating disorder (Ward, 2008).
  • Women with a history of an eating disorder should be monitored frequently during pregnancy and after they give birth. The stress of childbirth, rapid hormonal changes, sleep deprivation and the pressure of coping with a newborn may put women with a history of an eating disorder at increased risk of a postnatal relapse (Lowes et al, 2012; NICE, 2017).
  • Eating disorders can lead to long-term serious health conditions like developing osteoporosis. They can also result in problems with vital organs like kidneys, brain and nerves, and can lead to heart damage or heart failure (NHS, 2018b).

How will an eating disorder affect my baby?

During pregnancy it’s important to eat a healthy, balanced diet to help provide you and your baby with vital nutrients. Eating a varied diet will help your baby to grow and develop and will form a foundation for your child’s later health (NICE, 2014).

Some evidence suggests having an eating disorder like anorexia during pregnancy might increase the risk of your baby:

  • having a lower birthweight
  • being at higher risk of stillbirth.

(Lowes et al, 2012)

What support is there during pregnancy?

If you’re pregnant and have an eating disorder, you should have a health professional (usually your GP or midwife) supporting you during your pregnancy and after your baby arrives (NICE, 2017). They will help you prepare for changes that will happen to your body and should regularly check how you’re getting on (NHS Choices, 2018a). They can also support you in maintaining a healthy diet, mental health and lifestyle, including trying to stop any harmful behaviour related to controlling weight gain (Beat, 2017; NICE, 2017; NHS Choices 2018a).

How do I get help for my eating disorder?

It’s brave to recognise you need support. It’s also important to get help, especially if you’re pregnant. This will help ensure a healthy pregnancy for you and your baby and a good recovery from childbirth (NICE, 2017; NHS, 2018b).

Seek support by:

  • talking to your partner, someone in your family or a friend.
  • speaking to your GP or midwife.
  • finding out more about eating disorders from NHS Choices.
  • talking in confidence to an adviser from eating disorders charity Beat on 0808 801 0677 or youth helpline on 0808 801 0711.

(NHS, 2018a)

Read Christina's story about having an eating disorder while pregnant. She offers tips and advice to other mums going through a similar experience.

How can I support someone with an eating disorder?

  • If you think someone you know might have anorexia or another eating disorder, let them know you're worried about them and listen to what they say.
  • Support and encourage them to talk to their GP – you could suggest going with them.

(Beat, 2017; NICE, 2017; NHS Choices 2018a)

This page was last reviewed in February 2018

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Talk in confidence to an adviser from eating disorders charity Beat by calling their adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711.

Find out more about eating disorders from NHS Choices.

Beat. (2018) Types of eating disorder. Available at: https://www.beateatingdisorders.org.uk/ [accessed 6th September 2018].

Eating Disorders and Pregnancy (2018) Managing eating disorder symptoms in pregnancy. Available at: http://www.eatingdisordersandpregnancy.co.uk/project/managing-eating-disorder-symptoms-pregnancy/ [accessed 6th September 2018].

Lowes H, Kopeika J, Micali N, Ash A. (2012) Anorexia nervosa in pregnancy. The Obstetrician & Gynaecologist. 14:179-187. Available at: https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1744-4667.2012.00110.x

Mind. (2017) Eating problems. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/eating-problems/types-of-eating-disorders/#.W5GPeLgnZPY [accessed 6th September 2018].

NHS Choices. (2018b) Overview: anorexia nervosa. Available at: https://www.nhs.uk/conditions/anorexia/ [accessed 6th September 2018].

NHS. (2018a) Eating disorders. Available at: https://www.nhs.uk/conditions/eating-disorders/ [accessed 6th September 2018].

NICE. (2014) Maternal and child nutrition. Available at: https://www.nice.org.uk/guidance/ph11/chapter/2-Public-health-need-and-practice [accessed 6th September 2018].

NICE. (2017) Eating disorders: recognition and treatment. NICE guideline [NG69]. Available at: https://www.nice.org.uk/guidance/ng69/ifp/chapter/Pregnancy-and-eating-disorders [accessed 6th September 2018].

NIH. (2016) Eating disorders. Available at: https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml [accessed 6th September 2018].

Rocco PL, Orbitello B, Perini L, Pera V, Ciano RP, Balestrieri M. (2005) Effects of pregnancy on eating attitudes and disorders: a prospective study. J Psychosom Res. 59(3):175-79. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16198191 [accessed 6th September 2018].

Ward VB. (2008) Eating disorders in pregnancy. BMJ. 336(635):93-96. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190274/ [accessed 6th September 2018].

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